The story of Shehnaz – an IDP in Jalozai Camp

Displacement from her hometown in Bara Tehsil of Khyber Agency had taken a toll on the mental health of Shehnaz who was once a devoted and caring mother. With no hope of return, Shehnaz believed that life is useless and aimless. Shehnaz had arrived in Jalozai Camp in January 2012; since then she had lost interest in her family and children. Although food, medical care, shelter, drinking water, and sanitation facilities were provided to Shehnaz and her family in the camp, she had a strong desire to move back to her home town. This desire had made her mentally ill turning her into an un-productive mother who could not invest time in the proper upbringing of her children.
Dr. Ali – CAMP’s Health and Hygiene Surveillance Officer, found Shehnaz severely depressed during a Health Promotion Session in February 2014. He referred her to Ms. Rizwana Tabassum, Psychosocial Counsellor, for comprehensive examination and possible treatment. On examination, the Psychosocial Counsellor diagnosed Shehnaz as a patient of severe depression with co-morbid anxiety. “Depression is a common phenomenon in IDPs living in Jalozai Camp; the trend is more conspicuous in women than men. Causes like uncertain future, low self-esteem due to no permanent family income source, confined living with fewer opportunities for social gathering, and strong desire for an early but seemingly impossible repatriation, are contributory factors in depression” noted the counsellor.
The Psychosocial Counsellor adopted three pronged approach to treat Shehnaz. First, the counsellor conducted psychotherapeutic sessions adopting cognitive behaviour therapy and progressive muscle relaxation therapies with Shehnaz. Second, the counsellor provided psycho-education to the family members of Shehnaz. And finally, medication was administered to Shehnaz in consultation with Female Medical Officer present in the static health unit.
Three weeks of continuous treatment and regular follow-ups by the counsellor began giving some hope to Shehnaz for leading a normal life. The Psychosocial Counsellor noted, “Although her circumstances have not changed much, yet Shehnaz feels more confident now. Her stable voice, positive outlook, and positive thinking are clear signs that days of depression and anxiety are now over for her.” The counsellor further noted, “If it were up to Shehnaz alone, the treatment would have taken longer. The desire to be a productive mother, coupled with good family support, made her early recovery possible. The chances of recurring depression and associated complications are much higher in patients who are not supported by their families during their recovery phase. In case of Shehnaz, I have observed that her family also wanted her to recover soon and therefore supported her through this”. Shehnaz is living a content life now. She is optimistic that things will change and better days are not far away. After recovery she mentioned, “My good health is important to my family. I have realised that I should not be too worried about something that I cannot change.Instead Ishould focus on what I have, and how I can use my time in a better way to raise my family. I shall now send my children to school and shall also concentrate on their physical health. Allah willing, I shall try to spend my life happier as compared to the past”.
Relief could also be seen on the radiant face of Gul Mat Khan – Shehnaz’s husband, for whom his wife’s recovery meant a lot. He said, “Earlier I was not able to leave my wife and children alone at home. I was always fearful of any untoward accident due to fits of depression that she had. I was unable to go out and look for a job. Thanks to Allah, and thanks to CAMP, my wife can now take care of herself and the children, can cook and feed the children, and can perform other chores at home. Now that the year-long ordeal of my family has ended, I can confidently go out and try to earn bread and butter for my family”.

Ms. Rizwana Tabassum is attending Shehnaz at the clinic. Privacy and provision of candid environment to patients are the key considerations in consultationsShehnaz is pouring filtered water from pitcher. Her “henna” hands are the reflection of her normality and interest in daily life